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By William G. Bender, DDS
February 23, 2020
Category: Oral Health
Tags: dental injuries  
TakeTheseStepstoSaveaKnocked-OutTooth

Even though teeth are resilient, they're not indestructible. An accidental collision involving the face could damage teeth, even knocking a tooth completely out of its socket.

At first, it might seem like the end of the line for that particular tooth. But it doesn't have to be—if you know what to do. But you'll have to act quickly: The longer the tooth is out of its socket, the less chance it will survive long-term.

Here are the steps you should take to save a knocked-out tooth.

Find the tooth. It's important that you locate the missing tooth quickly. When you do, don't handle it by the root end: It still contains delicate periodontal cells that are essential if the tooth is going to rejoin with the ligaments and bone. Use clean water to rinse off any dirt or debris.

Reinsert the tooth. Holding it by the crown and not the root, reinsert the tooth into its empty socket, hopefully within an hour (the faster the better). You want to make sure it's good and snug, so apply a little force when you do this. Place some clean gauze or cloth between the tooth and its opposite on the other jaw, then have the person bite down and hold it in place.

Get immediate dental care. It's preferable to find a dentist as soon as possible (if not, then the nearest emergency medical facility). The dentist will x-ray the tooth to make sure it's positioned properly, and may adjust it further if necessary. They may also splint the tooth to adjacent teeth to help stabilize it until it fully reattaches with the jaw.

Again, time is of the essence—the quicker you can perform the above steps, the better the tooth's chances. Any delay could jeopardize the tooth's ability to reattach, or it could shorten its lifespan.

You can also get guidance on treating a knocked-out tooth and other dental emergencies with a free mobile app developed by the International Association of Dental Traumatology (IADT). Just look in your Android or IOS app store for ToothSOS.

If you would like more information on what to do during a dental emergency, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “When a Tooth is Knocked Out.”

By William G. Bender, DDS
February 13, 2020
Category: Oral Health
Tags: oral cancer  
TobaccoOneBaseballTraditionWeCanDoWithout

While sports like football, basketball and soccer have exploded in popularity over the last few decades, many Americans still have a soft spot for the granddaddy of them all: baseball. While technology has changed many aspects of the game, many of its endearing traditions live on.

Unfortunately, one baseball tradition isn’t so endearing and definitely hazardous to health—tobacco, primarily the smokeless variety. Players and coaches alike, even down to the high school level, have promoted or at least tolerated its use.

But there are signs this particular baseball tradition is losing steam. Not long ago, the San Francisco Giants became the first major league baseball team to prohibit tobacco in its home stadium—on the field as well as in the stands. The move was largely in response to a law passed by the City of San Francisco, but it does illustrate a growing trend to discourage tobacco use in baseball.

While smoking, chewing or dipping tobacco can certainly impact a person’s overall health, it can be especially damaging to the teeth, gums and mouth. Our top oral health concern with tobacco is cancer: Research has shown some correlation between tobacco use (especially smokeless) and a higher risk of oral cancer.

You need look no further than the highest ranks of baseball itself to notice a link between tobacco and oral cancer. Although from different eras, Babe Ruth and Tony Gwynn, both avid tobacco users, died from oral cancer. Other players like pitcher Curt Schilling have been diagnosed and treated for oral cancer.

Cancer isn’t the only threat tobacco poses to oral health. The nicotine in tobacco can constrict blood vessels in the mouth; this in turn reduces the normal flow of nutrients and disease-fighting immune cells to the teeth and gums. As a result, tobacco users are much more susceptible to contracting tooth decay and gum disease than non-users, and heal more slowly after treatment.

That’s why it’s important, especially in youth baseball, to discourage tobacco use on the field. While most of baseball’s traditions are worthy of preservation, the chapter on tobacco needs to close.

If you would like more information on the oral health effects of tobacco, please contact us or schedule an appointment for a consultation.

By William G. Bender, DDS
February 03, 2020
Category: Oral Health
Tags: oral appliance  
TakeCareofYourDentalAppliancetoExtenditsLongevity

What do dentures, retainers and nightguards have in common? Along with orthodontic aligners and athletic mouthguards, they’re all types of removable dental appliances. They also share another commonality: each one depends on the wearer caring for it to ensure its longevity.

The most important thing you can do for your appliance is to clean it regularly. Don’t use toothpaste, though, even with dentures: while your natural tooth enamel can handle the abrasive particles in toothpaste, your appliance’s materials may not. Toothpaste can create tiny scratches that can harbor disease-causing bacteria. Instead, use liquid dish detergent or hand soap with warm water.

Although boiling water may disinfect your appliance, it’s not advisable to use. Even hot water can distort plastic components and warp the appliance’s fit in your mouth. Likewise, don’t use bleach, which can fade the plastic color used to resemble gum tissue and break down the material’s composition. When you clean your appliance, use a brush — but not the one you use for your natural teeth. Use a soft toothbrush, a nail brush or a specialized brush for appliances like dentures.

You should also protect your appliance from damage. Some appliances like dentures have parts that can break if they’re dropped on a hard surface — like the porcelain in your sink. To prevent this, place a towel in the sink to cushion the appliance if it accidentally slips from your hand during cleaning. And when the appliance isn’t in your mouth, don’t keep it on a low table or night stand where small children or pets can easily get their hands (or paws) on it.

And one more thing: don’t wear your denture appliance around the clock — take it out, for instance, while you sleep. Leaving dentures in interferes with the acid-neutralizing and antibacterial function of your mouth’s saliva, which could increase your risk of disease (and bad breath).

Appliances can be an expensive investment in your dental health. By following these guidelines you’ll help protect that investment for years to come.

If you would like more information on caring for your dental appliance, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “10 Tips for Cleaning Your Oral Appliance.”

By William G. Bender, DDS
January 24, 2020
Category: Oral Health
Tags: celebrity smiles   retainer  
MargotRobbieKnowsAGreatSmileIsWorthProtecting

On the big screen, Australian-born actress Margot Robbie may be best known for playing devil-may-care anti-heroes—like Suicide Squad member Harley Quinn and notorious figure skater Tonya Harding. But recently, a discussion of her role in Peter Rabbit proved that in real life, she’s making healthier choices. When asked whether it was hard to voice a character with a speech impediment, she revealed that she wears retainers in her mouth at night, which gives her a noticeable lisp.

“I actually have two retainers,” she explained, “one for my bottom teeth which is for grinding my teeth, and one for my top teeth which is just so my teeth don't move.”

Clearly Robbie is serious about protecting her dazzling smile. And she has good reasons for wearing both of those retainers. So first, let’s talk about retainers for teeth grinding.

Also called bruxism, teeth grinding affects around 10 percent of adults at one time or another, and is often associated with stress. If you wake up with headaches, sore teeth or irritated gums, or your sleeping partner complains of grinding noises at night, you may be suffering from nighttime teeth grinding without even being aware of it.

A type of retainer called an occlusal guard is frequently recommended to alleviate the symptoms of bruxism. Typically made of plastic, this appliance fits comfortably over your teeth and prevents them from being damaged when they rub against each other. In combination with stress reduction techniques and other conservative treatments, it’s often the best way to manage teeth grinding.

Orthodontic retainers are also well-established treatment devices. While appliances like braces or aligners cause teeth to move into better positions, retainers are designed to keep teeth from moving—helping them to stay in those positions. After active orthodontic treatment, a period of retention is needed to allow the bite to stabilize. Otherwise, the teeth can drift right back to their old locations, undoing the time and effort of orthodontic treatment.

So Robbie has the right idea there too. However, for those who don’t relish the idea of wearing a plastic appliance, it’s often possible to bond a wire retainer to the back surfaces of the teeth, where it’s invisible. No matter which kind you choose, wearing a retainer can help keep your smile looking great for many years to come.

If you have questions about teeth grinding or orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “The Importance of Orthodontic Retainers.”

By William G. Bender, DDS
January 14, 2020
Category: Oral Health
Tags: pain management  
IsThereaBetterWaytoManagePainWithoutNarcotics

The ongoing opioid addiction epidemic has brought together government, law enforcement and healthcare to find solutions. The focus among doctors and dentists has been on finding ways to reduce the number of opioid prescriptions.

Opioids (or narcotics) have been a prominent part of pain management in healthcare for decades. Drugs like morphine, oxycodone or fentanyl can relieve moderate to extreme pain and make recovery after illness or procedures much easier. Providers like doctors and dentists have relied heavily on them, writing nearly 260 million narcotic prescriptions a year as late as 2012.

But although effective when used properly, narcotics are also addictive. While the bulk of overall drug addiction stems from illegal narcotics like heroin, prescription drugs also account for much of the problem: In 2015, for example, 2 million Americans had an addiction that began with an opioid prescription.

The current crisis has led to horrific consequences as annual overdose deaths now surpass the peak year of highway accident deaths (just over 54,000 in 1972). This has led to a concerted effort by doctors and dentists to develop other approaches to pain management without narcotics.

One that’s gained recent momentum in dentistry involves the use of non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs like acetaminophen, ibuprofen or aspirin work by dilating blood vessels, which reduces painful inflammation. They’re available over the counter, although stronger doses require a prescription.

NSAIDs are effective for mild to moderate pain, but without the addictive properties of narcotics. There are some adverse health consequences if taken long-term, but limited use for pain or during post-procedure recovery is safe.

Many dentists are recommending NSAIDs for first-line pain management after most dental procedures. Narcotics may still be prescribed, but in a limited and controlled fashion. As part of this new approach, dentists typically combine ibuprofen and acetaminophen: Studies have shown the two work together better at reducing pain than either one individually.

Still, many aren’t eager to move away from the proven effectiveness of narcotics to primarily NSAIDs. But as these non-addictive drugs continue to prove their effectiveness, there’s hope the use of addictive opioids will continue to decrease.

If you would like more information on pain management practices in dental care, please contact us or schedule an appointment for a consultation.





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